Sinai Health System creates unit to handle psychiatric crises in the ER


Sinai Health System in Chicago has created a crisis stabilization unit to handle psychiatric patients who come to the emergency room and help reduce the likelihood of unnecessary hospital admissions.

Leslie Zun, M.D., chairman of emergency medicine at Sinai Health System, told Hospitals & Health Networks in a video interview that the emergency room typically serves as a safety net for patients facing a psychiatric crisis.

“Emergency departments are notoriously the place that police, families, other folks in the community bring psychiatric patients, when they may just be having a dispute with their roommate,” Zun told H&HN. “And who takes care of the dispute resolution? Oh, the emergency department must be the place to take that patient.”

Zun, who is also the president of the American Association for Emergency Psychiatry, told the publication that psychiatric emergencies have created a significant increase in volume in the ED, and that about 9.3 percent of all ER patients come in for treatment with some kind of mental health problem.

At Sinai, the crisis stabilization unit monitors patients for as many as 23 hours and offers patients counseling. In addition, the unit team works to get patients back on needed medications, Zun said, and directs them to needed future treatment.

It's vital that hospitals address psychiatric emergencies especially as the healthcare industry moves to a value-based, accountable care model, according to Zun. Hospitals and health systems must integrate more mental health treatment options, he said, and work with treatment centers that handle issues like drug abuse. In time, he said, organizations will be able to care for these patients in an acute stabilization unit rather than as inpatients, a better solution for the patient and accountable care organizations.

- listen to the interview